Drug companies would be required to list prices in advertisements under a Trump administration proposal released Monday.

Under the new proposal, which was announced by Health and Human Services Secretary Alex Azar, drug manufacturers would need to state the list price of a 30-day supply of any drug that is covered through Medicare and Medicaid and costs at least $35 a month.

The plan is the boldest step the administration has taken to date as part of its efforts to bring down drug prices, and puts the administration squarely at odds with the powerful prescription drug lobby.

“Patients deserve to know what a given drug will cost when they’re being told about the benefits and risks it may have,” Azar said during a speech Monday in Washington, D.C.

“And they deserve to know when a drug company has pushed its prices to abusive levels, and they deserve to know this every time they see a drug advertised to them on TV.”

The proposal will be officially published Wednesday, and will be open for public comment for 60 days.

According to HHS, the 10 most commonly advertised drugs have list prices ranging from $535 to $11,000 per month for a usual course of therapy. Under the proposal, companies would be required to post that information in clear, legible text onscreen at the end of the ad.

HHS officials said the agency will publish a list of companies that don’t comply with the policy. Those companies would also be subject to potential litigation, officials said during a press call.

The pharmaceutical industry opposes the proposal, arguing it would confuse consumers because a drug’s list price is often lower than what the patient will actually pay.

PhRMA, the deep-pocketed trade group representing pharmaceutical companies in the U.S., tried getting ahead of Azar’s announcement, telling reporters Monday morning that its members would begin directing patients to more information about drug costs in television ads.

Every ad mentioning a prescription drug by name will include a voiceover or text telling patients to go to a company-sponsored website where they can find information about the list price, as well as a range of potential out-of-pocket costs and potential patient assistance.

“We want patients to have more cost information and support using direct-to-consumer advertising,” said PhRMA President Steven Ubl, but “just including list prices is not sufficient and would be misleading.”

Azar acknowledged PhRMA’s plan in his speech Monday afternoon, but said it doesn’t go far enough.

A wide-ranging bill authorizing the use of medical marijuana for ailments from cancer to post-traumatic stress disorder was passed Monday night by the Iowa Senate, although it’s unlikely to win approval in the Iowa House.…

DES MOINES — The Senate voted 45-5 Monday to approve an expanded medical marijuana law that would allow making and dispensing cannabis products in Iowa for adults to legally possess and use under a doctor’s care to treat an array of medical conditions, but under tight regulation.

“I think this is the right thing to do,” said Sen. Matt McCoy, D-Des Moines, who said many of the ill people who advocated for Senate File 506 have died waiting for the Legislature to act.

Senators passed “The Compassionate Use of Cannabis Act,” a new law that would replace Iowa’s existing but limited cannabis oil statute.

It lays out an expanded approach to reclassify marijuana and open it as a limited medical alternative under tight regulation and supervision. The bill now goes to the House, where its prospects are uncertain.

“Let’s do the right thing for the people out there who are suffering,” said Sen. Brad Zaun, R-Urbandale. The bill was supported by 25 Republicans 19 Democrats and one independent, while four Republicans and one Democrat opposed it.

Under provisions of SF 506, Iowa would license up to four manufacturers to “possess, cultivate, transport or supply medical cannabis” by July 2, 2018, so up to 12 licensed dispensaries could begin distribution to qualified adult Iowans by July 16, 2018. Interested makers and dispensers would pay a non-refundable $15,000 state fee.

Canada’s biggest pharmacy chain is hoping to be the first in the country to sell legal medical marijuana over the counter. Shoppers Drug Mart has confirmed that it applied to the Canadian government earlier this year to become a licensed medical marijuana distributer.

In email statement Tuesday, Shoppers Drug Mart spokeswoman Tammy Smitham confirmed the news adding, “We have no intention of producing medical marijuana, but we do want the ability to dispense medical marijuana to our patients in conjunction with counseling from a pharmacist.”

Under Canadian federal law, patients with prescriptions are only able to purchase medical marijuana directly from one of a few dozen licensed producers. Producers are required to securely ship pot directly to the patient by mail order only.

“We believe that allowing medical marijuana to be dispensed through pharmacy would increase access, safety, quality and security for the thousands of Canadians who use the drug as part of their medication therapy,” explained Smitham. “We are hoping that the Government of Canada will revise the current regulations to allow for the dispensing of medical marijuana at pharmacy.”

In August, the Canadian Pharmacist Association argued in favor of clinical oversight from pharmacists to minimize harms associated with use of all forms of marijuana in its submission to the federal task force studying marijuana legalization and regulation.

There’s a body of research showing that painkiller abuse and overdose are lower in states with medical marijuana laws. These studies have generally assumed that when medical marijuana is available, pain patients are increasingly choosing pot over powerful and deadly prescription narcotics. But that’s always been just an assumption.

Now a new study, released in the journal Health Affairs, validates these findings by providing clear evidence of a missing link in the causal chain running from medical marijuana to falling overdoses. Ashley and W. David Bradford, a daughter-father pair of researchers at the University of Georgia, scoured the database of all prescription drugs paid for under Medicare Part D from 2010 to 2013.

They found that, in the 17 states with a medical-marijuana law in place by 2013, prescriptions for painkillers and other classes of drugs fell sharply compared with states that did not have a medical-marijuana law. The drops were quite significant: In medical-marijuana states, the average doctor prescribed 265 fewer doses of antidepressants each year, 486 fewer doses of seizure medication, 541 fewer anti-nausea doses and 562 fewer doses of anti-anxiety medication.

But most strikingly, the typical physician in a medical-marijuana state prescribed 1,826 fewer doses of painkillers in a given year.

These conditions are among those for which medical marijuana is most often approved under state laws. So as a sanity check, the Bradfords ran a similar analysis on drug categories that pot typically is not recommended for — blood thinners, anti-viral drugs and antibiotics. And on those drugs, they found no changes in prescribing patterns after the passage of marijuana laws.

“This provides strong evidence that the observed shifts in prescribing patterns were in fact due to the passage of the medical marijuana laws,” they write.

In a news release, lead author Ashley Bradford wrote, “The results suggest people are really using marijuana as medicine and not just using it for recreational purposes.”

One interesting wrinkle in the data is glaucoma, for which there was a small increase in demand for traditional drugs in medical-marijuana states. It’s routinely listed as an approved condition under medical-marijuana laws, and studies have shown that marijuana provides some degree of temporary relief for its symptoms.

The Bradfords hypothesize that the short duration of the glaucoma relief provided by marijuana — roughly an hour or so — may actually stimulate more demand in traditional glaucoma medications. Glaucoma patients may experience some short-term relief from marijuana, which may prompt them to seek other, robust treatment options from their doctors.

The tanking numbers for painkiller prescriptions in medical marijuana states are likely to cause some concern among pharmaceutical companies. These companies have long been at the forefront of opposition to marijuana reform, funding research by anti-pot academics and funneling dollars to groups, such as the Community Anti-Drug Coalitions of America, that oppose marijuana legalization.